CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Lost Rivers Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $56
Cash Discount Price: $71
vs. Medicare Baseline: 6.62x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Lost Rivers Medical Center is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 6.62x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)

Cash / Self-Pay: $71 (839%)

Insurance Median: $56 (662%)

Cash: $71 (839% of Medicare)

Ins. Median: $56 (662% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 662% of the Medicare baseline (a markup of 562%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Humana	$8 - $56	95%
Regence Blue Shield-All Other Plans	$8	95%
Provider Network Of America-All Plans	$15	177%
Select Health Brightpath-All Other Plans	$50	591%
Tricare	$50	591%
Ihcn Brightpath-All Other Plans	$53	626%
Va Pccc-All Plans	$54	638%
Blue Cross Blue Shield	$56 - $89	662%
Ihcn Brightpath Mcr Adv	$56	662%
Molina Mcr Adv-All Plans	$56	662%
Pacificsource Mcr Adv	$56	662%
Regence/Brightpth Slhp Mcr	$56	662%
Select Health Mcr Adv	$56	662%
Prime Hlth Mcr Adv	$59	697%
Aetna	$61 - $84	721%
Cigna	$83	981%
First Choice-All Plans	$83	981%
Pacificsource Navigator-All Other Plans	$85	1005%
UnitedHealthcare	$85	1005%
Altius Health Plan-All Plans	$86	1017%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $71.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lost Rivers Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.